Copyright
©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Oncol. Sep 24, 2025; 16(9): 109711
Published online Sep 24, 2025. doi: 10.5306/wjco.v16.i9.109711
Published online Sep 24, 2025. doi: 10.5306/wjco.v16.i9.109711
Swollen lymph node metastasis in gastric cancer: A forgotten prognostic signal in need of clinical action
Keykavous Parang, Department of Biomedical and Pharmaceutical Sciences, School of Pharmacy, Chapman University, Irvine, CA 92618, United States
Amir Nasrolahi Shirazi, Department of Pharmaceutical Sciences, Marshall B. Ketchum University, Fullerton, CA 92831, United States
Author contributions: Parang K contributed to this paper; Parang K designed the overall concept and outline of the manuscript; Parang K and Shirazi AN contributed to the writing and editing of the manuscript and reviewed the literature.
Conflict-of-interest statement: Both authors have nothing to disclose.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Keykavous Parang, PhD, PharmD, Tenured Professor, Department of Biomedical and Pharmaceutical Sciences, School of Pharmacy, Chapman University, 9401 Jeronimo Road, Irvine, CA 92618, United States. parang@chapman.edu
Received: May 19, 2025
Revised: June 15, 2025
Accepted: July 9, 2025
Published online: September 24, 2025
Processing time: 127 Days and 12.6 Hours
Revised: June 15, 2025
Accepted: July 9, 2025
Published online: September 24, 2025
Processing time: 127 Days and 12.6 Hours
Core Tip
Core Tip: Swollen lymph node metastasis (SLNM), defined by bulky nodal tumor deposits (> 3 cm on imaging or multiple > 1.5 cm nodes) in gastric cancer, confers a dramatically worse outcome. In a large recent cohort, SLNM was independently associated with approximately 50% higher mortality risk. This editorial emphasizes SLNM’s under-recognized prognostic value. Formally incorporating SLNM into gastric cancer staging and treatment algorithms (for example, prioritizing neoadjuvant chemotherapy) may improve risk stratification. Recognizing SLNM as a biomarker can enhance precision oncology approaches by identifying patients for intensified multimodal therapy.